Drugs associated with behavioral addictions: Real world analysis using the WHO pharmacovigilance database

Abstract

Objectives: Behavioral addictions (BA) are a newly recognized diagnostic entity. While some drugs are known to induce BA, some of them remains unknown. The aim of this study was to identify drugs for which B is not listed in the summaries of product characteristics. Methods: We conducted a search on Vigibase to identify health professional's cases where drugs are “suspect” coded with the following preferred terms: (1) ‘behavioral addiction’, (2) ‘gambling disorder’, (3) ‘gaming disorder’, (4) ‘compulsive sexual behavior’, (5) ‘bulimia nervosa’, (6) ‘binge eating’ and (7) ‘compulsive shopping’. We selected drugs “suspect” in at least five cases for which the summaries of product characteristics do not mention BA. We applied a downward descriptive process (drug only suspect, positive dechallenge, well-documented cases) together with a disproportionality analysis and a PubMed search. Results: We identified 24 drugs across 7 pharmacological classes: antidepressants, antipsychotics, antiepileptics, benzodiazepines, psychostimulants, antidiabetics and retinoids. Olanzapine was the only accompanied by well-documented cases with positive dechallenges, exhibiting significant disproportionality analysis and associated with publications from the PubMed search. Conclusion: Our results highlights that several drugs and notably olanzapine are associated with BA. Further research using definitions enabling the diagnosis of addictive disorders for various BA is warranted.